Nathan Chomilo, MD, FAAP, FACP🙅🏾‍♂️ Profile picture
medPeds▪️#Medicaid Medical Director▪️tweet racial/health equity,policy,early child,comic book stuff▪️he/him▪️Views mine▪️Akum-Foumban-Norwegian-Black Minnesotan
Feb 26, 2021 14 tweets 8 min read
Today’s MN #COVIDVaccine announcement is disappointing & largely fails to move the needle on equity.

I think understanding why & how it could likely worsen inequity requires a recap.

On 1/14 MN opened up vaccination to 65+ w/no subprioritization. What have we learned since?
🧵 1️⃣ There was no federal stockpile (as the previous WH administration HHS had eluded) to support this decision.

So now ~1 million Minnesotans believed they were at the front of the line but MN was getting ~60,000 new doses/week & still had not completed everyone in phase 1A
Dec 15, 2020 35 tweets 17 min read
I have enrolled in a #COVIDvaccine trial & last week got my first shot!!

But this wasn’t always my plan. I had a surprising amount of hesitancy early on. So I want to share how I worked through it.

This will probably be my longest thread ever. But stick w/me! (1/) An avid advocate that #vaccinessavelives I found myself personally & professionally skeptical about the speed with which vaccines were being developed & politicized.

So I read about #COVIDvaccine development & listened to @NEJM’s podcast weekly podcasts.apple.com/us/podcast/new… (2/)
Oct 5, 2020 4 tweets 3 min read
“When we fight to change children’s circumstances, THAT is when we keep children healthy. THAT is Socially-Responsive Pediatrics”

@DrOmolara opening up the final #AAP2020 plenary with powerful perspective .@DrOmolara breaks down common frameworks:

Cultural competency doesn’t deliver justice

Structural competency doesn’t dismantle structural inequity

We need to move to Social responsiveness to deliver justice & dismantle structures of oppression

YES🙌🏾🙌🏾
#AAP2020
Oct 4, 2020 8 tweets 4 min read
Appreciate @AMLandryMD opening the #AAP2020 Minority Health Equity & Inclusion program by sharing his “origin story”

A patient asked him why all the black patients in his ED were put in the hallway

He studied that ? & found the patient’s observation to be true. His path was set This strikes me as a particularly powerful example of why community needs to be at the table as we work to address structural racism in medicine.

They will see problems & solutions even the most antiracist of physicians, policy makers & researchers simply can’t.

#AAP2020
Oct 4, 2020 5 tweets 5 min read
Speaking at #AAP2020 Rev @CornellWBrooks starts by illustrating that #EmmettTill #TamirRice & #GeorgeFloyd are the recognized victims of police violence but that the trauma of over overpolicing is felt by whole communities & generations of children. .@AmerAcadPeds section on Minority Health Equity & Inclusion Chair @DrHeardGarris has described this even more broadly as “vicarious racism”

Similar to secondhand smoke, vicarious racism has real impacts on child health

sciencedirect.com/science/articl…

#aap2020
#BlackLivesMatter
Oct 4, 2020 5 tweets 3 min read
Looking forward to this talk by @BioethxMark on access to care for undocumented children in the US.
#AAP2020

There are ~2 million undocumented children in the US 6 states + D.C. provide healthcare coverage for undocumented children (props to CA, NY, IL, MA, OR, WA)

#Medicaid is available for children w/special healthcare needs

33% have no healthcare access

#AAP2020
Sep 26, 2020 5 tweets 4 min read
Dr. David Jones did a fantastic job laying out the history, harm & questions race-based medicine presents & @bcunningMDPHD w/a wonderful job covering how cognitive dissonance plays into the barriers we face addressing this w/our colleagues

#mnmed20 For those ready to address the use of race-based medicine I highly recommend this fantastic piece by @RheaBoydMD, @EdwinLindo, @Lachelle_Dawn & @mclemoremr 🙌🏾

#mnmed20

healthaffairs.org/do/10.1377/hbl…
Sep 2, 2020 21 tweets 16 min read
Committed to ending racial health inequities?

You need to be talking to your patients about their civic health.

Voting and health inequities are closely linked.

Thread.
#MedTwitter
#MedStudentTwitter
#MedEd

(1/) Families separated at the border
Another school shooting
#COVID19’s racist impact
The ongoing fight for #Medicaid
#ClimateChange

All impact the health of our communities. Outcomes that are heavily influenced by participation in, or lack of, voting.
#VoteHealth #VoteKids (2/)
Aug 19, 2020 5 tweets 3 min read
Excited to report that the @AmerAcadPeds resolution, Prohibit the Use of Race-Based Medicine, I submitted & adapted from my MN colleagues @dr_okah & @AndreaWestbyMD’s groundbreaking work, not only passed but was a Top 10 selection!!
#MedTwitter #MedEd

aappublications.org/news/2020/08/1… Image This resolution calls for:

1️⃣ the Academy to end the practice of using race as a proxy for biology or genetics in all their educational events & literature, &
May 27, 2020 9 tweets 6 min read
What happened to #GeorgeFloyd isn’t new. It won’t be the last time we witness the torture and murder of a neighbor because they were living while Black.

Not as long as we continue to raise children in a racist society. (1/)

THREAD
#JusticeForGeorgeFloyd
#BlackLivesMatter As parents, pediatricians & educators we have an obligation to change our communities & country by moving our children from the mindset that being simply “not racist” is enough to one where we strive to be actively ANTI-racist.

We don’t need your horror, we need your ACTION(2/)
Apr 16, 2020 4 tweets 3 min read
“As governments craft policies to make communities whole again @RRHDr hopes they understand they many communities of color weren’t whole before the #COVID19 pandemic hit”

YES

Some f/u thoughts to this solid report by @BrandtMPR & how media can continue to improve the narrative You don’t have to look further than the replies to @MPRnews’ tweet to see how talking about #disparities alone can actually reinforce false & negative stereotypes about the impact of structural racism. Image
Apr 11, 2020 4 tweets 4 min read
I appreciated @MPRnews covering #COVID19 racial disparities. Though the discussion @MarkZdechlik & @DataANDInfo had was lacking.

Simply put: Any discussion re: racial disparities NEEDS to cover structural racism. Period.

Disparities are a Symptom. Structural Racism the disease. Without discussion of structural racism revealing questions go unasked & unexplored.

The obvious one in MN is how are we doing in testing overall along racial lines?

Are our numbers low in part because of how we’ve structured who gets tested for #COVID19?
Feb 2, 2020 31 tweets 27 min read
While we should recognize Black History every month I do appreciate the opportunity #BlackHistoryMonth gives us to reflect.

In that spirit each day I’m going to recognize those in the community who have helped me grow & are writing their part (some literally) of our history. 2/1 - @BDTSpelman’s Why Are All the Black Kids Sitting Together in the Cafeteria should be required reading. For everyone.

Her work inspired my advocacy for pediatricians to do more to stop racism at its roots in early childhood. 🙏🏾
#BlackHistoryMonth

Jan 24, 2020 7 tweets 5 min read
OPPORTUNITY GAP
#OPPORTUNITYGAP
OPPORTUNITY GAP
#OPPORTUNITYGAP
OPPORTUNITY GAP
#OPPORTUNITYGAP
OPPORTUNITY GAP
#OPPORTUNITYGAP
OPPORTUNITY GAP
#OPPORTUNITYGAP
OPPORTUNITY GAP
#OPPORTUNITYGAP
OPPORTUNITY GAP
#OPPORTUNITYGAP
OPPORTUNITY GAP
#OPPORTUNITYGAP Also disturbing, "NCES reported a promising trend of more black and Latino teens & young adults understanding the need for a high school diploma, GED or some other form of educational certificate"

They actually think the problem is we don't understand the importance of education
Dec 5, 2019 5 tweets 4 min read
Next up at #SPHHealthyFutures a breakout session on Counteracting the Anti-Science Movement with @sarahgollust, @ShawnOtto & @BrianSouthwell Image @ShawnOtto’s factors contributing to the growing Anti-Science movement

🔸Complexity: science has become so complex to some it may seem magical
🔸Objectivity: media has abandoned it “there is no objectivity”
🔸Grievance-Identity: Social Media exacerbates this

#SPHHealthyFutures ImageImage
Dec 5, 2019 10 tweets 6 min read
Excited to start my #SPHHealthyFutures day learning from this awesome panel about how we can help build resilient communities (& hopefully highflying ways to reinforce the resilience that already exists!)
🙌🏾🙌🏼🙌🏿🙌🏻 ImageImage Cyrus Batheja from @UHC
“Understanding of peoples’ social circumstance has a greater impact than their medical circumstances. But when you connect the two you can have an even greater impact”
#SPHHealthyFutures Image
Nov 19, 2019 6 tweets 6 min read
Dr. @rebekahgeemd talking w/@ddiamond about the importance of #Medicaid

“Health care hits home”

#USofCare2019 Image @rebekahgeemd points out that #Medicaid expansion should be a no-brainer.

States around Louisiana have had rural hospital closures. Louisiana has had none.

This is also backed up by nationwide data from @GeorgetownCCF

ccf.georgetown.edu/2018/10/29/mor…

#USofCare2019
Nov 18, 2019 6 tweets 5 min read
Another great panel moderated by @mccarthyjohnb featuring the great work in North Carolina of @betseytilson @jrlumpkin & @DeniseNeunaber

#USofCare2019 Image @jrlumpkin talks about supporting the “Drivers of Health” like housing, job support, transportation & nutrition.

By looking at outcomes systems can drive change not just for their patients, but improve health for ALL

#USofCare2019
Nov 18, 2019 9 tweets 8 min read
Awesome panel up next with @NSmithholt12, @MollyVoris & @rebekahgeemd & moderated by Chiquita Brooks-LaSure talking about Effective State Strategies to improve Health & health care.

#USofCare2019 Image @rebekahgeemd shares about Louisiana’s model for treating Hepatitis C
1️⃣ universal access
2️⃣ engaging primary care providers to treat
3️⃣ promoting social capital around treatment
4️⃣ supporting primary prevention

#USofCare2019
Nov 7, 2019 6 tweets 4 min read
@GoodmanCenter Kicks off the afternoon guiding us on how to share our story

#ROR30years Image “When you have other people telling your story for you, then you have the world’s oldest form of ‘social media’” - @GoodmanCenter

#ROR30years
Nov 7, 2019 4 tweets 3 min read
@reachoutandread co-founder Robert Needlman (introduced by National Medical Director @PerriKlass ) starts off the day by taking us through the history of #ROR30Years & where we are going. ImageImage Dr. Needlman shares some of the amazing impacts of our model:
🔹serving as a cultural bridge
🔹helping children recover from trauma & natural disasters
🔹⬆️ attendance at well child checks
🔹improving clinician/parent relationships
🔹improving parent/child connection
#ROR30Years